Provider Demographics
NPI:1427033364
Name:FREEMAN, GINA M (DPM)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9551
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809
Mailing Address - Country:US
Mailing Address - Phone:302-765-2505
Mailing Address - Fax:302-765-2090
Practice Address - Street 1:2323 PENNSYLVANIA AVE STE 2B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1332
Practice Address - Country:US
Practice Address - Phone:302-765-2505
Practice Address - Fax:302-384-8046
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEEI0000136213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001069450Medicaid
DE0001069450Medicaid
DEG00673Medicare ID - Type Unspecified